P-536 - Immediate-release and extended-release formulations of second-generation antidepressants for the treatment of major depressive disorder in adults

2012 ◽  
Vol 27 ◽  
pp. 1 ◽  
Author(s):  
M. Van Noord ◽  
K. Thaler ◽  
L. Morgan ◽  
G. Gartlehner
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Extended Release ◽  
Second Generation ◽  
Immediate Release ◽  
Major Depressive ◽  
Extended Release Formulations

Immediate-release and extended-release formulations of second-generation antidepressants for the treatment of major depressive disorder in adults

2011 ◽  
Vol 26 (S2) ◽  
pp. 1289-1289
Author(s):  
M. Van Noord ◽  
G. Gartlehner ◽  
R. Hansen ◽  
L. Morgan ◽  
K. Thaler ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Extended Release ◽  
Second Generation ◽  
Patient Adherence ◽  
Immediate Release ◽  
Cochrane Library ◽  
Open Label ◽  
Major Depressive ◽  
Extended Release Formulations

IntroductionExtended-release formulations of antidepressants have been marketed as a strategy to increase patient adherence. Changes in the formulation of drugs, however, could be related to changes in efficacy and tolerability. Among second-generation antidepressants, bupropion, fluoxetine, mirtazapine, paroxetine, and venlafaxine are available in immediate- and extended-release formulations.ObjectivesTo compare the efficacy, tolerability, and adherence of immediate- versus extended-release formulations of second-generation antidepressants for the treatment of major depressive disorder (MDD) in adults.AimTo provide an evidence base for clinicians when choosing immediate- or extended-release formulations of antidepressants for the treatment of MDD.MethodsWe conducted a comparative effectiveness review for the U.S. Agency for Healthcare Research and Quality searching PubMed, EMBASE, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two people independently reviewed the literature, abstracted data, and rated the risk of bias.ResultsSix RCTs and one observational study provided evidence about the comparative efficacy, tolerability, and adherence of bupropion SR (sustained release) versus bupropion XL (extended release), fluoxetine daily vs. fluoxetine weekly, paroxetine IR (immediate release) versus paroxetine CR (continuous release), and venlafaxine IR versus venlafaxine XR (extended release). Overall, no substantial differences in efficacy and safety could be detected. Open-label and observational evidence indicated better adherence for bupropion XL and fluoxetine weekly than for immediate-release medications. No differences in adherence could be detected between paroxetine IR and paroxetine CR.ConclusionsOur findings indicate similar efficacy and tolerability between immediate- and extended-release formulations. Whether extended-release formulations lead to better adherence remains unclear.

Use of a Second Generation Antipsychotic among Patients Diagnosed with Major Depressive Disorder in the United States

2012 ◽  
Vol 26 (4) ◽  
pp. 235-241
Author(s):  
David A. Sclar ◽  
Linda M. Robison ◽  
Lawrence J. Cohen ◽  
Kimberly K. Laubmeier ◽  
Iftekhar D. Kalsekar ◽  
...  
Keyword(s):  
United States ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Second Generation ◽  
The United States ◽  
Major Depressive ◽  
Second Generation Antipsychotic

scholarly journals Efficacy of levomilnacipran extended-release in major depressive disorder: pooled analysis of 5 double-blind, placebo-controlled trials

CNS Spectrums ◽  
2014 ◽  
Vol 20 (2) ◽  
pp. 148-156 ◽  
Author(s):  
Stuart A. Montgomery ◽  
Carl P. Gommoll ◽  
Changzheng Chen ◽  
William M. Greenberg
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Extended Release ◽  
Rating Scale ◽  
Pooled Analysis ◽  
Major Depressive ◽  
Double Blind ◽  
Madrs Score ◽  
Wide Range ◽  
Remission Rates

Introduction/ObjectivePost hoc analyses were conducted to evaluate the efficacy of levomilnacipran extended-release (ER) in subgroups of patients with major depressive disorder (MDD).MethodsData were pooled from 5 completed Phase II/III studies. Patients were categorized by sex, age, MDD duration, recurrence of MDD, current episode duration, number of prior episodes, and baseline Montgomery–Åsberg Depression Rating Scale (MADRS) score. Efficacy was evaluated by MADRS least squares (LS) mean change from baseline, response (MADRS improvement ≥50%), and remission (MADRS ≤10).ResultsIn the pooled population, treatment with levomilnacipran ER versus placebo resulted in greater improvement in MADRS score (−15.8 versus −12.9; LS mean difference, −2.9; P < .001) and higher response rates (44.7% versus 34.5%; P < .001). Comparable treatment effects were found in most subgroups. Remission rates in the overall population were higher for levomilnacipran ER versus placebo (27.7% versus 21.5%; P < .05); notably high remission rates were seen in patients with baseline MADRS score < 30 (48.8% versus 28.9%; P < .001).DiscussionClinically meaningful improvements in depressive symptoms were found across subgroups, including statistically significant outcomes for both response and remission.ConclusionLevomilnacipran ER was efficacious across a wide range of MDD patients, including men and women, ages 18–78, with varying histories and symptom severity.

Extended Release Quetiapine Fumarate Monotherapy in Major Depressive Disorder

2009 ◽  
Vol 70 (4) ◽  
pp. 526-539 ◽  
Author(s):  
Andrew J. Cutler ◽  
Stuart A. Montgomery ◽  
David Feifel ◽  
Arthur Lazarus ◽  
Mikael Åström ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Extended Release ◽  
Major Depressive ◽  
Quetiapine Fumarate

scholarly journals Treatment Response of Add-On Esketamine Nasal Spray in Resistant Major Depression in Relation to Add-On Second-Generation Antipsychotic Treatment

2020 ◽  
Vol 23 (7) ◽  
pp. 440-445 ◽  
Author(s):  
Markus Dold ◽  
Lucie Bartova ◽  
Siegfried Kasper
Keyword(s):  
Major Depressive Disorder ◽  
Confidence Interval ◽  
Depressive Disorder ◽  
Nasal Spray ◽  
Second Generation ◽  
Mean Difference ◽  
Inadequate Response ◽  
Major Depressive ◽  
Second Generation Antipsychotics ◽  
Second Generation Antipsychotic

Abstract In this meta-analysis, we aimed to estimate and compare the efficacy of add-on treatment of antidepressants with esketamine nasal spray and second-generation antipsychotics in patients with nonpsychotic major depressive disorder and inadequate response to antidepressants. Searching for acute-phase, double-blind, placebo-controlled, randomized trials, we found 22 second-generation antipsychotic (n = 8363) and 3 intranasal esketamine (n = 641) studies. Mean change in the Montgomery Åsberg Depression Rating Scale total score served as outcome. We determined a higher mean difference (vs placebo) for the pooled esketamine nasal spray trials (mean difference = 4.09, 95% confidence interval: 2.01 to 6.17) than for the pooled second-generation antipsychotic augmentation trials (mean difference  = 2.05, 95% confidence interval: 1.51 to 2.59). Thus, the effect size for intranasal esketamine was nearly twice as high as those for the second-generation antipsychotics. This indicates high efficacy of add-on esketamine nasal spray in treatment-resistant major depressive disorder compared with other well-established, evidence-based pharmacological options such as augmentation with second-generation antipsychotics.

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